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The male and female orgasms are very similar subjectively. When women and men are asked to described the sensations they feel during arousal and orgasm but excluding gender-specific anatomical terms, the descriptions are remarkably similar, and involve feelings of inevitability when the orgasm is imminent. Of course there are anatomical differences and women have the general advantage that most can have (or be educated to have) multiple orgasms. Also, a good proportion of women can experience a very prolonged orgasm called a ’status orgasmus’ which, as far as I know, no man can. These can last many seconds and must be fun :-). Also, many women are capable of imagining themselves all the way to orgasm though no doubt this may involve a lot of muscle tensing and cannot really be described as being without physical stimulus ­ rather no fingers are involved. Women also tend to have more orgasms in their sleep than men who usually only do this during teenage years, and several, mainly anti-depressant, drugs (e.g. Prozac, Zoloft, Wellbutrin) are known to cause spontaneous orgasms in women though they do not affect men the same way - in these cases the orgasm can even sometimes be brought on voluntarily by yawning!

Pain thresholds increase during arousal (e.g. during masturbation) and reach their maximum during orgasm. It is likely that cerebral endorphins may be involved. Electroencephalography has shown which regions of the brain and brain stem are involved in orgasm, though most of the mechanisms of the physiological rather than psychological processes are in the spinal cord and paraplegics can be stimulated to have orgasm.

The standard textbook description of female excitation and orgasm goes like this: A prolonged period of arousal, a plateau, orgasm proper and resolution. The same phases can be identified in men. Major studies which are still often quoted are those of Kimsey and of Masters and Johnson who tackled the sensitive topic of female sexuality in what was effectively the dark ages of the post-war 20th century.

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In the excitement phase, often induced by thought alone, involves the following set of processes:

The nipples typically become erect and the clitoris also becomes turgid and it expands a little (though not much), and this may result in it becoming a bit more visible in some women with medium to large ones. Clitoral erection, more properly called tumescence, is due to increased arterial blood flow to the clitoris and reduced venous drainage and so is essentially identical to the process of penile erection but the degree of expansion is much less and involves little change in length, though the change in thickness and turgidity of the long clitoral shaft is very easily appreciated. Increasing heart rate and blood pressure, and increasing genital blood flow also result in gradual expansion of the inner and outer labia and vaginal lubrication. Vaginal lubrication results mostly from a process called transudation ­ that is, the increased blood flow (vasocongestion) of the vaginal wall causes blood and lymphatic fluids to be forced through the tissue into the vagina where it appears as a lot of tiny sweat-like drops on the vaginal walls. Additional vaginal lubrication comes from the cervix which is well-supplied with mucous glands. The amount and thickness of a woman’s vaginal lubrication may well depend on her stage in the menstrual cycle primarily because of the changes in the cervical mucus.

There is also lubrication of the inner lips resulting from glandular secretions from the mucous membranes and possibly from the Skene’s glands (paraurethral glands) that open at two small, sometimes quite visible, pores, one on either side of the urethral opening (at 5 and 7 o’clock if the genitals are arranged with clitoris at 12 o’clock).

As the arousal continues, the swelling of the labia causes the inner lips to part and spread outwards ­ thus making the opening of the vagina more obvious. The increased blood flow causes the woman’s genitals to change colour, from flesh tones to at least pinkish, but in women who have had children (it isn’t clear if pregnancy alone causes this or childbirth is important) the colour change can be more extreme and her genitals can become almost a deep wine red.

The colour of the vaginal walls also changes in the same way, and internally the vaginal cavity expands and the inner two thirds can form a rather large space; evolutionarily this is probably to produce a cavity in which sperm will be kept in close proximity to the cervix and not simply run out after the male has shed his load. On the other hand, the outer third of the vagina (the introitus) becomes tighter due to the increased blood flow to the region (reported as a corpus spongiosum ­ i.e. similar tissue to that in the penis and clitoris). Internally the positions of the uterus moves causing the vagina to elongate, and the position of the cervix changes ­ collectively these changes in the internal vaginal arrangement are often referred to as “tenting”.

Late in the excitement phase the breasts are reported to swell, though it is hard to find detailed measurements.

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The plateau is the final phase of excitement when basically all excitement parameters are at max and she is waiting to get herself over the edge, usually focusing her thoughts very much on her genitals or other arousing things. At this time spontaneous contractions of the anal sphincter, and muscles in the upper legs and pelvic region are common, and increased semi-involuntary movements of the hips usually indicates the imminence of orgasm.

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